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For several years, I have coordinated a critical appraisal course for residents. Participants, who were organised initially as a traditional journal club, would gather weekly and review an important research paper that either had recently been published or had been found during a Medline search while attempting to answer a question that arose during clinic. The housestaff consistently rated the course highly and appeared to be happy with it. When I ran into them after they were in practice, however, they would frequently reminisce fondly about “the days when we had time to read journals.”
As for many educational interventions during residency, the traditional journal club seemed appropriate but unfortunately did not fit with “real world” practice. Several major factors influence the uptake of the practice of evidence-based medicine in primary care, including time constraints and the volume of clinical literature.1–4 However, several recent developments have made tackling these obstacles possible: high quality pre-appraised evidence resources; multi-intervention continuing education models that fit the learners' needs, setting, and social environment; and improved technology that makes delivering knowledge to the point of care possible.
After considering these factors, I arrived at a conclusion similar to that of other evidence-based medicine proponents,5—that evidence-based clinicians of the future may …
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